Shunt-related intracranial abscess caused by Staphylococcus lugdunensis in a hydranencephalic patient.

BACKGROUND

Staphylococcus lugdunensis is a coagulase-negative staphylococcus with aggressive and rapidly progressive infectious behavior. This organism has emerged as an important pathogen implicated in both community-acquired and nosocomial infections, including meningitis, brain abscess, catheter-related bacteremia, and ventriculoperitoneal shunt infection.

CASE DESCRIPTION

We report the first known case of Staphylococcus lugdunensis intracranial abscess in a pediatric hydranencephalic patient, caused by a ventriculoperitoneal shunt-related infection. Further magnetic resonance imaging (MRI) confirmed a large abscess within the cranium that demonstrated multiple loculations. The patient received externalization of the right occipital ventricular catheter with evacuation of the brain abscess. Medical management included one week of intrathecal antibiotic treatment, and she was discharged on long-term intravenous rifampin and vancomycin, leading to cure of the infection.

CONCLUSION

This case suggests that if Staphylococcus lugdunensis is identified, a virulent and prolonged clinical course with the production of destructive lesions, similar to those with S. aureus, should be expected. A course of antibiotic therapy and aggressive management that may include surgical treatment will be needed.